MLI Newsletter - September 12th 2011

Dr. Bocar Daff, head of the Reproductive Health Division in Senegal's Ministry of Health and Prevention, is determined to reposition the Division as a driving force behind overall reproductive health and development efforts within the Ministry. For the past year, MLI has been working with Dr. Daff and his team in order to elevate the dialogue around reproductive health and family planning within the government and engage partners to strategically address policy issues. Dr. Daff is working to strengthen the Division's high level advocacy skills in order to create and disseminate relevant, up-to-date, and targeted messages and information to the appropriate audiences. Dr. Daff will be sharing Senegal's experience at the 2nd International Conference on Family Planning with a presentation on "Advocating from Within: How Ministerial Leaders Can Advance Reproductive Health and Family Planning Policy."

From the perspective of Mary Robinson, former president of Ireland and U.N. High Commissioner of Human Rights, donors should do much more to support health in developing countries – especially when those nations take bold steps to improve health care. In a speech last week at the annual meeting of Finnish Heads of Mission at the Ministry of Foreign Affairs in Finland, Robinson said that diplomats should look more closely at the example set by MLI in its work in five countries. Referencing Sierra Leone's free care initiative, Robinson stated that initially the government lacked donor support, "The donor community was against it because Sierra Leone was not ready. They were too poor of a country for this. And that, I think, is also part of the problem. If the climate of the donor community is keeping poor countries with limited access to health care because they are poor countries, it's perpetuating the problem." To improve health outcomes, Robinson said, political and donor support must strengthen country plans, making, "health care for all a sustainable reality."

In 2005, Senegal launched a free delivery care policy providing free deliveries at all health posts and free cesarean sections to all women at district and regional level hospitals. However, most other reproductive health services including ante-natal care, post-natal care, and family planning continue to have user fees and health outcomes are discouraging. Senegal has a maternal mortality ratio of 401 per 100,000 live births (DHS, 2005) and a contraceptive prevalence rate of 11.8 (DHS, 2005). Concerned that these user fees may be a major access barrier for women, the Ministry of Health and Prevention in Senegal is working with MLI to conduct a study on the implication of user fees on demand and utilization of reproductive health services. The study is currently underway in select health facilities with the highest and lowest rates of reproductive health service utilization in Dakar and an additional three pre-selected zones. In addition, a sampling of women utilizing reproductive health services in the target health facilities will be interviewed. The study will illustrate how user fees at the point of service are impacting demand and utilization and, additionally, if user fees are eliminated, what is the impact on health facilities in terms of revenue generation and what are potential financial mechanisms to lessen the impact of lost revenue from user fees. The results of the study will be available this fall.